College of Nursing and Health Sciences
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Browsing College of Nursing and Health Sciences by Author "Adey-Wakeling, Zoe"
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Item Hemiplegic Shoulder Pain Reduces Quality of Life After Acute Stroke: A Prospective Population-Based Study(Wolters Kluwer Health Inc, 2016-10-31) Adey-Wakeling, Zoe; Liu, Enwu; Crotty, Maria; Leyden, James; Kleinig, Timothy; Anderson, Craig; Newbury, JonathonItem Incidence and Associations of Hemiplegic Shoulder Pain Poststroke: Prospective Population-Based Study(Elsevier, 2014-09-28) Adey-Wakeling, Zoe; Arima, Hisatomi; Crotty, Maria; Leyden, James; Kleinig, Timothy; Anderson, Craig; Newbury, JonathonItem Suprascapular Nerve Block for Hemiplegic Shoulder Pain Post Stroke: Subgroup Analysis of Pain Response(Jacobs Publishers, 2015-09-01) Adey-Wakeling, Zoe; Crotty, Maria; Liu, Enwu; Shanahan, Ernst MichaelBackground and Aims: Suprascapular nerve block is an effective intervention for hemiplegic shoulder pain post stroke.This study aims to ascertain baseline variables associated with significant shoulder pain reduction in a post-stroke population receiving suprascapular nerve block versus placebo. Methods: Post hoc subgroup analysis of data from a randomised controlled trial. Participants included 64 patients with hemiplegic shoulder pain (mean onset 12 weeks post stroke); 32 received suprascapular nerve block and 32 received placebo subcutaneous normal saline injection. Results: Greater rates of pain reduction were found in participants with severe baseline pain (p=0.0454) and participants aged under eighty (p=0.0417). Persons aged over eighty demonstrated poor response to intervention. Heterogeneity of sex interaction was associated with reduced placebo effect in females (p=0.036). Conclusions: Participants with severe baseline pain or aged <80 years were more likely to have reduced pain following injection. Patients >80 warrant further investigations prior to consideration of this intervention. Stroke subtype and level of spasticity were not associated with response.Item Suprascapular nerve block for shoulder pain in the first year after stroke: a randomized controlled trial(American Heart Association, 2013-11) Adey-Wakeling, Zoe; Crotty, Maria; Shanahan, Ernst MichaelBackground and Purpose: Shoulder pain is a common complication after stroke which can impede participation in rehabilitation and has been associated with poorer outcomes. Evidence based treatments for hemiplegic shoulder pain are limited. Suprascapular nerve block (SSNB) is a safe and effective treatment of shoulder pain associated with arthritic shoulder conditions, but its usefulness in a stroke population is unclear. Methods: We undertook a randomised controlled trial assessing the effectiveness of SSNB in a population of 64 stroke patients (onset < 1 year) with hemiplegic shoulder pain. The primary outcome was pain measured on a visual analogue scale (VAS). Secondary outcomes were disability (Modified Rankin Scale, Croft Disability Index) and quality of life (EuroQol Health Questionnaire). All participants were assessed prior to randomisation, and at 1, 4 and 12 weeks post intervention. Both groups continued with routine therapy. Results: Whilst both intervention and control groups demonstrated reduction in pain score, participants who received SSNB consistently demonstrated superior, statistically significant pain reduction compared to placebo. Mean VAS reduction in the SSNB group was over 18mm greater than participants receiving placebo injection. The number needed to treat with SSNB to reduce one stroke survivor’s pain by 50% at four weeks is 4. No significant differences in function or quality of life were observed. No adverse events were reported. Conclusions: Suprascapular nerve block is a safe and effective treatment for patients with hemiplegic shoulder pain.Item Upper limb rehabilitation following stroke: current evidence and future perspectives(Future Medicine, 2013-12) Adey-Wakeling, Zoe; Crotty, MariaStroke is a leading cause of disability worldwide, with risk increasing with age. Upper limb hemiparesis is common and associated with persistent impairments and associated disabilities. Older stroke populations often suffer multiple co-morbidities and restoring independence is complex. Recovery of upper limb function can be crucial for them to return to independent living and to participate in community life. This review describes upper limb recovery post stroke, and some of the new therapeutic approaches available to promote recovery. Technologies (including virtual reality and telehealth) offer the opportunity for more home based therapies, longer programs, greater access to rehabilitation for older people however the trials continue to exclude older people so acceptability is poorly understood.